GI Tract & Vessels (Ach) - W2 Flashcards
What is the function and features of the stomach?
- receives food + saliva from esophagus and acts as reservoir where the digestive enzymes can break it down.
- Parts
- greater curvature - attaches greater omentum
- lesser curvature - lesser omentum
- fundus - left 5th interspace
- cardiac orifice - has cardiac sphincter
- body
- pylorus
- rugae - folds
What are the parts of the pylorus of the stomach, and what does the pyloric sphincter do?
- Pyloric antrum
- pyloric canal
- pyloric sphincter
- controls passage of chyme into duodenum
- true sphincter - thick ring of circular muscle
- normally in tonic contraction
What are rugae, where are they found and what is their purpose?
- folds of mucosa inside stomach
- increase surface area
Most common of the hiatal hernias, how is it acquired, what is it a risk factor for and who is the most common population?
-
Acquired hiatal hernias
- most common (99%)
- occur in middle-aged people
- gastroesophageal region –> slides superiorly into thorax through lax esophageal hiatus
- risk factor for GERD
- What is the least common acquired hiatal hernia?
- what does it involve?
- When do you repair?
- what is it a risk for?
-
Paraesophageal (rolling) hiatal hernia
- less common (1%)
- pouch of perineum that contains the fundus of the stomach and extends for the esophageal hiatus ANTERIOR to the esophagus
- associated with pain, nausea, and vomitting
- refer for REPAIR
- high incidence of incarceration & ischemia
Peptic Ulcer
- what is it
- common site
- what can it cause
- erosion of the mucous membranes of the stomach or duodenum
- ONLY occurs in tissues in contact with gastric juices
- most common in duodenal cap (80%)
- 2nd most common is posterior wall of duodenum.
- erosion could perforate the wall & erode pancrease
- gastroduodenal artery massive hemorrhage
- associated w/H. pylori
How can you tell the difference between jejunum & ileum?
-
Jejunum
- often EMPTY
- thicker, redder, more vascular
- well developed circular folds of mucosa (plicae circularis)
- few arcade arterioles - much longer arterioles
- areas fat free
-
Ileum
- lymphatic nodules (peyer’s patches)
- more fat
- numerous, shorter arcade arterials
What are 3 things found on the large intestine and what are they?
- Teniae coli - outer longitudinal muscle fibers that are confined to 3 parallel bands
- Haustra - sacculations between teniae
- Appendices epiploicae - small sacs of fat covered w/peritoneum suspeneded from the external surface
What does inflammation of the appendix cause?
Where is pain referred intially and why?
What will become affected late?
-
Appendicitis
- when it ruptures can lead to peritonitis
- referred pain to T10 due to autonomic nerves and where they convege
- late = rebound tenderness at McBurney’s point - inflammation affects SNS of parietal layer
What is ulcerative colitis and what may be needed?
- severe inflammation and ulceration of the colon and rectum
- may need colectomy = permanet opening between ileum and anterior abdominal wall
What is a colostomie?
- establishes an opening between various parts of the colon and anterior abdominal wall - creates an artificial anus
What is a diverticululum?
What causes it?
Who is it common in?
Most commonly found where?
-
Diverticululum
- abnormal pouch that forms in the wall of the colon caused by increased intracolonic pressure pushing against weak intestinal wall.
- most commonly in sigmoid colon
- 10% of people over 40
- usually asymptomatic until inflamed
What are the 3 main arteries off the abdominal aorta?
- Celiac Trunk
- Superior mesenteric artery
- Inferior Mesenteric artery
What does the celiac trunk supply?
where does it arise?
What are its branches?
- supplies foregut
- arises from abdominal aorta T12
- Branches
- left gastric
- Common hepatic
- Splenic
What are the two branches of the common hepatic?
- Hepatic artery proper
- Gastroduodenal artery